Several popular books claim that eating gluten in wheat will cause just about every imaginable symptom a person can have, and that avoiding wheat will cure these symptoms. This is true for people with celiac disease, but celiac disease affects only about one person in a hundred.

If you suffer from any of these symptoms and believe you may have celiac disease, ask your doctor to do a blood test called a celiac panel. People who are allergic to gluten usually have certain proteins called antibodies in their bloodstream. They may also have severe damage to the lining of their intestinal tract that can be diagnosed by an intestinal biopsy. However, avoiding gluten for many months can make both the blood test and intestinal biopsy normal, so you have to get these tests before you start a gluten-free diet. The odds are very strong that the tests will be negative and you will not have celiac disease.

Non-Celiac Grain Intolerance
People who have only abdominal symptoms (gas, diarrhea, swollen belly) may suffer from grain intolerance and you could be cured just by avoiding wheat, rye, barley and other grain flours. Grain intolerance is not diagnosed with a blood test; you must avoid foods made with grains for many months and see if you improve on this avoidance diet. You are less likely to suffer from grain intolerance and be more likely to suffer celiac disease if you also have the non-abdominal symptoms listed above.

Recent studies show that most people who have abdominal symptoms from eating grains actually have no problem with gluten. Instead, they are unable to break down and absorb certain carbohydrates in grains. These carbohydrates are not absorbed in your small intestines and pass to your colon where bacteria break down these non-absorbable carbohydrates to cause gas, cramping and alternating constipation and diarrhea.

How Your Intestines Normally Handle Carbohydrates
Your body cannot absorb whole foods. Food is separated in your stomach and intestines into carbohydrates, fats and proteins. Your body cannot absorb these components either. Carbohydrates must be broken down into single sugars as you can absorb only single sugars from your intestines. Protein must be broken down into single amino acids or chains of amino acids, and fat must be broken down into fatty acids.

Most foods that come from plants are made up primarily of carbohydrates: sugars that are single or in molecules of two or three up to millions of sugars bound together. Starches contain hundreds and thousands of sugars bound together. Fiber contains up to millions of sugars bound together so tightly that the human intestines cannot separate them and therefore cannot absorb them.

Grains contain long chains of sugar molecules called amylopectins and amylose. The digestive enzymes in your intestines are incredibly inefficient in breaking down these sugar chains into single sugars and therefore you cannot absorb them. Cooking gelatinizes these starches so your intestinal enzymes can partially break down these starches and some of them can be absorbed from your intestines into the bloodstream. Grinding whole grains into a flour also markedly increases your ability to absorb them from your intestines. However most of the fiber in whole grains travels to the colon where bacteria can ferment them to cause gas, belly cramps and diarrhea.

Gluten-Free Diet Foods
There is no harm in trying a gluten-free diet to see if it will correct abdomminal problems. If a gluten-free diet causes you to avoid flour and other refined carbohydrates, you will probably lose weight as well. However, if your problems are caused by non-absorbable carbohydrates rather than by gluten, you will not improve if you substitute "gluten-free" foods that are made from rice flour, tapioca starch, corn meal or corn flour, or other gluten-free but carbohydrate-rich flours. These foods will cause the same problems you experience with foods made with wheat flour. This year the North American public will pay more than $15 billion for gluten-free foods and most people will be wasting their money on foods that are of little value to them. Gluten-free junk food is still junk food. See Gluten-Free Diets Ca Harm

About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities.
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